From good to great: what the Forward View must do next

The mental health strategy in the Five Year Forward View is promising but needs to go further to be of most help to service users

It is welcome news that the government has a mental health implementation plan for the Five Year Forward View.

Giving mental health its own stage with a specific five-year plan, set of targets and dashboard of metrics, is not only very promising but necessary. If achieved, increasing access to mental health interventions will be a major step forward in the way we care for the nation’s mental health and emotional wellbeing.

My concern is that the plan is not innovative enough. It is offering a solution too similar to the way we have always delivered mental health interventions – primarily with talking therapies and medication at NHS, outpatients, clinics or hospital settings delivered by therapists, nurses, social workers, psychiatrists and operational managers.

It is estimated that 25 per cent of people with a mental health problem access ongoing treatment, leaving 75 per cent left to cope by themselves or rely on informal support such as family or friends or non-specialist mental health practitioners such as their GP, social workers, teachers, housing workers and probation officers.

More of the same is not going to reach ever higher proportions of the population with a mental health need and cover the early prevention and maintenance ends of the treatment spectrum.

Traditional mental health treatments alone do not meet the population needs of people with mental health conditions

This is not to say traditional mental healthcare needs to be scrapped, but rather augmented with other promising approaches, such as:

task shifting, widely trialled in other countries with a shortage of mental health practitioners

place-based co-location of mental health practitioners within community services

online therapies/counselling

peer support interventions

smartphone app or avatar-based self-help and support

mindfulness and yoga in schools, colleges and workplaces

alternative drug treatments such as anti-inflammatory drugs and vitamin D supplements to reduce vulnerability to depression

increasing awareness through popular television; as has recently been on the increase with storylines in programmes such as Eastenders

use of personal health budgets so care is personcentric rather than providercentric

In addition, we should bear in mind that people need the basics before they can access mental health treatment – food, shelter/accommodation, a sense of safety in the environment and to be free of excessively stressful environments. Traditional mental health treatments alone do not meet the population needs of people with mental health conditions.

The mental health implementation plan of the FYFV is promising and welcome but could it be a missed opportunity to be even more forward thinking and innovative?